The European Randomized Study of Screening for Prostate Cancer (ERSPC), performed on 182,000 men, showed that automatic screening allowed to reduce death rate by 20%.
However, it also point the fact that to "save" a patient, 1,500 needed to be screened and 50 to be operated on. This is a real problem inasmuch as prostate cancer treatment has an important cost to the society and can lead to complications such as incontinence and impotence which breaks up significantly life quality of the patient.
Two problematics are highlighted with this circumstances:
1/ how to improve the diagnosis in order to identify patients having to be treated and ones having to be watched;
2/ how to shift from radical treatments to surgical intervention centred on the cancer.
As part of this project we will focus on the prostate biopsy gesture. It is the only gesture allowing to establish the diagnosis, to assess the disease pronostic, even select and plan the treatment. Samples are acquired using ultrasonic guidance and through the rectum. This gesture require a great dextérity to reach a target with precision and seems to be not repeatable between different operators. In the assistance product market there are in clinical assessement devices: navigation or positioning needle systems (especially robotic), either transrectal or perinal way. Whatever the approach, they are still subjected to constraints tied to the prostate mobility and deformation thus to the gesture ergonomic. The challenge in this field is to invent and to connect complementary technologies in a system answering to all these constraints fitting in the clinic and reglementary environnement.
We offer a unique comanipulation robotic device and image guided having as an objective not to do earlier diagnosis but to increase the precision of the gesture in order to increase the quality of the diagnosis to increase the therapeutic decision taking. It will be embedded in the UroStation® of the KOELIS compagny, equipped with a pioneering biopsy cartography system, to take the full charge of the surgical intervention quality. The device will provide a biopsy simulator allowing teaching of the gesture and the device manipulation. The system will use advanced ultrasound imaging and synthesis algorithms, real time deformable biomecanical patterns of the prostate thus command laws for comanipulation based on images and patterns.